Lena Claire Van Der List, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A17025 Issued in CA

Practice address

2516 Stockton Blvd
Sacramento, CA 95817-2208

Phone

(916) 734-2428

NPI assigned

Jun 6, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lvanderlist237702@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Sacramento

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1366513061
  Medicare reassignment NPD
• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment NPD
• Regents of the University of California

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1952998973
  Medicare reassignment NPD
• County of Sacramento

  • Radiology Clinic/Center
  • Sacramento, CA
  • NPI 1508936030
  NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD
• Regents of the University of Ca

  • Pediatrics Physician
  • Sacramento, CA
  • NPI 1386637346
  NPD
• Regents of the University of Ca

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1992930986
  NPD
• Regents of the Univ of Ca

  • Surgery Physician
  • Sacramento, CA
  • NPI 1427041698
  NPD (past)
• Regents of the Univ of Ca

  • Pulmonary Disease Physician
  • Sacramento, CA
  • NPI 1437142692
  NPD (past)
• Essent PRMC LP

  • Certified Registered Nurse Anesthetist
  • Paris, TX
  • NPI 1376541839
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1003265596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-2428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3160 Folsom Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958165202",
            "country_code": "US",
            "telephone_number": "916-734-5846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DER LIST",
        "first_name": "LENA",
        "middle_name": "CLAIRE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A17025",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne Adelle Van Cleave, M.A. DEGREE
• Aidan River Van Cleef
• Jennifer Van Conett
• Dana Marie Van Der Heide, MD/MPH
• Mary Van Der Linden
• Lohgan Elizabeth Van Deusen
• Jade A Van Dyck
• Zachary Nathaniel Van Dyck
• Paul Edmund Van Dyke
• Yavonda VR Van Dyke

• Pediatrics Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.